C43  lju  MiVtriSiTY  OP  !LU*iDi3  MDS^y 

AUG  22  1919 

f  University  of  Cincinnati 


Series  IV 


1918 


Voe.  I,  M  1 


Rules  and  Regulations 


Governing  the  Medical  Work,  Teaching,  and  Nursing 

/ 

in 

THE  MUNICIPAL  HOSPITALS  OF  CINCINNATI 

r  The  Cincinnati  General  Hospital 

The  Cincinnati  Tuberculosis  Sanatorium 


Adopted  by  the  Board  of  Trustees  of  the  University  of  Cincinnati, 
March  5,  1918,  in  accordance  with  the  power  vested  in  said  Board 
by  The  Charter  for  the  City  of  Cincinnati. 


Digitized  by  the  Internet  Archive 
in  2018  with  funding  from 

University  of  Illinois  Urbana-Champaign  Alternates 


https://archive.org/details/rulesregulationsOOuniv 


INDEX 


alphabetical 


PAGE 

Anesthetist  . 25 

Anesthetics,  Administration  of . 25 

Attending  Physicians  and  Surgeons . 18 

Assistant  Attending  Physicians  and  Surgeons . 18 

Appointments  and  Promotions . 18 

Attending  Staff . 19 

Authority  of  Nursing  Faculty . 11 

Authority  of  Attending  and  House  Staffs,  Nursing  Department . 12 

Authority,  Division  of . 12 

Assistants,  Nursing  Department . 12 

Attendants,  Nursing  Department,  Male  and  Orderlies . 13 

Attending  Physicians,  Surgeons,  and  Assistants  in  Laboratories . 29 

Bacteriologic  Laboratory . 26 

Cincinnati  General,  designed  for .  8 

Clerks,  Clinical . 25 

Consulting  Physicians  and  Surgeons . 19 

Custodian,  Library  . 15 

Cincinnati  Tuberculosis  Sanatorium . 27 

Directing  Medical  Staff . 17 

Director,  Assistant  . 17 

Director,  School  of  Nursing  and  Health . 11 

Director  of  Nurses,  Assistant . 12 

Dietitians  . 13 

Dietitian,  Tuberculosis  Sanatorium  . 30 

Emeritus  Members  of  Staff  . 20 

General  Rules,  Medical  Department  . 18 

Internes  and  Resident  Staff  . 21 

Internes,  Examination  of  . 21 

Internes,  Rules  and  Regulations  governing . 21 

Internes,  Tuberculosis  Sanatorium  . 29 

Laboratories,  Rules  governing  . 26 

Laboratories,  Bacteriologic . 26 

Laboratories,  Pathologic,  Director  of  . 25 

Library,  Medical  . 14 

Library  Committee  . 14 

Librarian  and  Assistant  Librarians  . 14,  15 

Medical  Record  . 16 

Medical  Department  . 16 

Medical  Library  . 14 


4 


RULES  AND  REGULATIONS 


PAG8 

Minors,  Admission  to  Hospital  .  8 

Maids,  Ward . 13 

Medical  Director  . 17,28 

Medical  Director,  Resident  . 28 

Medical  Director,  Assistant  . 28 

Medical  Residents,  Volunteer  . 29 

Nursing  Department  . 11 

Nurses,  Head  . ...13 

Nurses,  on  General  Duty  . 13 

Nurses,  Supervisor  of,  Tuberculosis  Sanatorium . 29 

Officers,  Executive,  Tuberculosis  Sanatorium . 28 

Pathologic,  Director  of . 25 

Patrons  of  Library,  Suggestions  and  Rules  for  . 15 

Privileges  of  Library  . 15 

Porters  . 13 

Patients,  Discharge  of . .  .  .8,  27 

Pharmacist  . 14 

Pharmacist,  Tuberculosis  Sanatorium  . 29 

Patients,  Tuberculosis  Sanatorium,  Discharge  of  . 27 

Physicians,  Tuberculosis  Sanatorium,  Resident,  Assistant . 29 

Physicians  and  Surgeons,  Attending  . 29 

Physicians  and  Surgeons,  Assistant  Attending  . 18 

Physicians  and  Surgeons,  Volunteer . 18 

Resident  Staff  . 20 

Resident  Staff  and  Internes  . 21 

Rules  and  Regulations  . 8,21 

Superintendent .  9 

School  of  Nursing  and  Health  . 11 

Superintendent,  Tuberculosis  Sanatorium  . 28 

School  of  Nursing  and  Health,  Tuberculosis  Sanatorium . 28 

Supervisor,  Night  and  Assistant  Night  . 12 

Supervisor  at  Contagious  Group  . 12 

Supervisor  at  Tuberculosis  Sanatorium  . 12 

Supervisors  and  Assistant  Supervisors,  Buildings . 13 

Visits,  Regulations  regarding .  9 

Visitors,  Regulations  regarding,  Tuberculosis  Sanatorium  . 28 

Workers,  Nursing  Department  . 13 


INDEX 


ACCORDING  TO  DEPARTMENTS 


Hospitals,  City  of  Cincinnati:  page 

Cincinnati  General,  designed  for  .  8 

Tuberculosis  Sanatorium,  established  for  . 27 

Cincinnati  General  Hospital: 

Anesthetist  . 25 

Anesthetics,  Administration  of  . 25 

Clerks,  Clinical . 25 

Medical  Record  Clerk . 16 

Internes: 

Examination  of . 21 

Internes  and  Resident  Staff  . 21 

Rules  and  Regulations  governing . 21 

Laboratories: 

Rules  governing  . 26 

Bacteriologic . 26 

Pathologic,  Director  of . 25 

Medical  Department: 

Medical  Department  of  the  Hospitals . 16 

Directing  Medical  Staff . 17 

Superintendent  and  Director  of  the  Hospitals  . 17 

Assistant  Director . 17 

Attending  Physicians  and  Surgeons . 18 

Assistant  Attending  Physicians  and  Surgeons  . IS 

Appointments  and  Promotions . 18 

Volunteer  Physicians  and  Surgeons  . 18 

General  Rules  . IS 

Attending  Staff  . 19 

Consulting  Physicians  and  Surgeons . 20 

Emeritus  Members  of  Staff  . 20 

Receiving  Physicians  . 20 

Resident  Staff  . 20 

Resident  Staff  and  Internes  . 21 

Medical  Library: 

Rules  governing  . 14 

Library  Committee  . 14 

Librarian  . 14 

Assistant  Librarians . 15 

Custodian  . 15 

Patrons,  Suggestions  and  Rules  for  . 15 

Privileges  . 15 


6  RULES  AND  REGULATIONS 

Minors:  pagb 

Admission  to  Hospitals  .  8 

Nursing  Department: 

School  of  Nursing  and  Health  . 11 

Director  of . 11 

Authority  of  Faculty  . 11 

Authority  of  Attending  and  House  Staffs  . 12 

Authority,  Division  of .  A  2 

Assistant  Director  of  Nurses . 12 

Supervisor,  Night . 12 

Assistant  Supervisor,  Night  . 12 

Supervisor  at  Contagious  Group  . 12 

Supervisor  at  Tuberculosis  Sanatorium  . 12 

Dietitians  . 13 

Supervisors  and  Assistant  Supervisors,  Buildings . 13 

Nurses,  Head  . 13 

Nurses  on  General  Duty  . 13 

Attendants,  Male  and  Orderlies . 13 

Maids,  Ward . 13 

Porters  . 13 

Workers . 13 

Patients: 

Discharge  of  .  8 

Pharmacist  . 14 

Rules  and  Regulations . S,  21 

Superintendent .  9 

Visits: 

Regulations  regarding .  9 

Tuberculosis  Sanatorium: 

Attending  Physicians,  Surgeons,  and  Assistants  in  Laboratories  ...  29 

Dietitian  . 30 

Internes  .  29 

Medical  Director . 28 

Medical  Director,  Resident  . 28 

Medical  Director,  Assistant  . 28 

Medical  Residents,  Volunteer  . 29 

Nurses,  Supervisor  of  . 29 

Officers,  Executive  of  . 28 

Patients,  Discharge  of . 27 

Pharmacist  . 29 

Physicians,  Resident,  Assistant  . 29 

School  of  Nursing  and  Health  . 28 

Superintendent . 28 

Visitors,  Regulations  regarding  . 28 


EXTRACT  FROM  THE  CHARTER  FOR  THE 
CITY  OF  CINCINNATI 


“Paragraph  V.  HOSPITALS— 

“1.  The  administrative  and  executive  work  of  the  municipal  hospitals 
shall  be  controlled  and  directed  by  the  Director  of  Public  Safety,  except  as 
hereinafter  stated. 

“2.  The  medical  work,  teaching  and  nursing  in  the  hospitals  shall  be 
controlled  and  directed  by  the  Board  of  Directors  of  the  University  of  Cincinnati 
in  the  manner  hereinafter  stated. 

“3.  The  Superintendent  of  the  Hospitals  shall  be  appointed  by  the 
Director  of  Public  Safety  with  the  approval  of  the  Directing  Medical  Staff, 
and  shall  not  be  under  Civil  Service  rules',  he  shall  have  authority  with  the 
approval  of  the  Director  of  Public  Safety  to  appoint  and  remove  all  non-medical 
employes,  subject  at  all  times  to  such  Civil  Service  rules  as  may  apply.  He 
shall  be  responsible  to  the  Director  of  Public  Safety  for  the  efficient  and  economi¬ 
cal  management  of  the  hospitals',  and  shall  be  a  member  of  the  Directing 
Medical  Staff,  and  Secretary  of  the  same. 

“4.  The  Directing  Medical  Staff  of  the  Hospitals  shall  consist  of  the 
Superintendent,  the  Dean  of  the  Medical  Faculty  of  the  University^  and  the 
Directors  of  the  service  of  the  several  Professional  Departments. 

“5.  The  Board  of  Directors  of  the  University  shall  appoint  to  the  Director¬ 
ship  of  each  Department  of  the  Municipal  Hospitals  a  professor  from  the 
corresponding  department  of  the  University. 

"6.  The  appointment  of  all  subordinate  members  of  the  Medical  Staff 
shall  be  made  by  the  Directing  Medical  Staff,  with  the  approval  of  the  Board 
of  Directors  of  the  University. 

“7.  The  Directing  Medical  Staff  shall  determine  the  manner  in  which 
the  medical  work  and  teaching  in  the  hospitals  shall  be  organized  a?id  con¬ 
ducted,  provided,  however,  that  medical  instruction  shall  be  open  to  the  students 
of  any  medical  college  in  Cincinnati  which  is  recognized  by  the  State  Medical 
Board  of  Ohio,  or  by  any  licensing  authority  which  shall  thereafter  be  provided 
by  the  State  of  Ohio. 

"8.  There  shall  be  a  School  of  Nursing  and  Health  under  the  Depart¬ 
ment  of  Medicine  of  the  University  of  Cincinnati  and  a  Director  thereof.  The 
Director  and  Faculty  of  the  School  of  Nursing  and  Health  shall  be  appointed 
by  the  Board  of  Directors  of  the  University  of  Cincinnati. 


8 


RULES  AND  REGULATIONS 


“9.  The  Director  of  the  School  of  Nursing  and  Health  shall  be  the  Director 
of  the  Nursing  Department  of  the  Municipal  Hospitals,  and  the  other  members 
of  the  faculty  of  said  school  shall  be  appointed  to  such  supervisory  positions 
in  the  Nursing  Department  of  the  Hospitals  as  the  Board  of  Directors  of  the 
University  shall  designate .” 

'  "r  '  ’^**‘‘a***_  . 

CINCINNATI  GENERAL  HOSPITAL 

The  Cincinnati  General  Hospital  is  designed: 

1.  For  the  treatment  of  all  medical  and  surgical  dis¬ 
eases  that  may  be  cured  or  improved,  including  contagious 

diseases. 

2.  For  the  teaching  of  the  practice  of  medicine  in  all  of  its 
varied  branches. 

3.  For  investigation  and  research  in  the  various 
branches  of  the  science  of  medicine. 

4.  For  the  instruction  of  young  women  (in  the  School 
of  Nursing  and  Health)  in  the  principles  and  practice  of  the 
science  of  nursing. 

■4 

Admission  of  Minors. — When  patients  under  legal  age  are  admitted, 
whose  conditions  require,  or  are  likely  to  require,  any  operative  procedure, 
the  Superintendent  and  Medical  Director  and  the  Admitting  Physician 
shall  endeavor  to  obtain  a  written  permission  (upon  a  special  blank  form) 
from  the  patients’  nearest  responsible  relatives,  or  guardians,  at  the  time 
of  admission,  for  such  operative  procedure,  unless  in  the  opinion  of  the 
surgeon  in  charge  immediate  operation  is  considered  imperative. 

All  children  under  twelve  years  of  age  admitted  to  the  Cincinnati 
General  Hospital  shall  be  assigned  to  the  Pediatric  Service;  the  exception 
to  this  rule  shall  be  emergency  surgical  cases. 

Discharge  of  Patients. — Neither  the  Resident  Staff  nor  Internes 
shall  discharge  patients,  but  after  obtaining  the  written  consent  of  the 
Attending  Physicians  or  Surgeons  they  shall  recommend  patients  for  dis¬ 
charge  to  the  Superintendent  of  the  Hospital  as  “cured,”  “improved,” 
or  “not  improved,”  respectively.  This  rule  shall  also  apply  to  all  patients 
mentally  competent  who,  upon  their  own  initiative,  request  to  be  discharged. 

Rules  and  Regulations. — All  children  under  the  age  of  fourteen 
years;  all  unmarried  mothers;  and  patients  who  have  received  all  the 
benefit  that  can  be  offered  from  treatment  in  the  hospital,  but  who  are 
still  unable  to  earn  a  livelihood,  shall,  after  the  Attending  Physician  or 
Surgeon  has  recommended  their  discharge,  be  referred  to  the  Department 
of  vSocial  Service  for  follow-up  work. 

Monthly  reports  shall  be  filed  by  the  Attending  Staff  with  the  Super¬ 
intendent,  of  all  patients  on  their  services  who  have  been  in  the  hospital 
sixty  days  or  more,  with  reasons  for  their  longer  stajr,  if  such  be  necessary. 


CINCINNATI  MUNICIPAL  HOSPITALS 


9 


The  Superintendent  may  discharge  any  patient  for  improper  conduct 
or  other  violation  of  the  rules. 

When  the  patient  demands  his  or  her  discharge  against  the  advice  of 
the  Attending  Physician,  the  Superintendent  may  grant  such  discharge, 
provided  the  patient  (or  nearest  responsible  relative  or  friend,  if  one  can 
be  found)  sign  a  written  acknowledgment  that  such  discharge  is  against 
advice,  and  granted  under  protest. 

This  shall  not  apply  to  those  held  by  order  of  the  Court,  Board  of 
Health,  or  for  other  institutions. 

Regulations  Regarding  Visits. — 

Visitors  to  Patients  in  Public  Wards. — Visits  from  immediate  rela¬ 
tives  or  friends  of  a  patient  will  be  allowed  daily  from  1 :30  p.m.  to  2:30  p.m. 
Those  who  cannot  visit  during  the  day  may  do  so  between  7:00  p.m.  and 
8:00  p.m.  on  Tuesdays  and  Thursdays. 

All  visitors  must  obtain  permission  to  enter  the  wards  at  the  office 
in  the  Administration  Building. 

No  visitor  shall  be  permitted  to  visit  any  patient  at  other  than  regular 
visiting  hours,  except  by  special  permission  of  the  Superintendent. 

Visitors  are  not  to  remain  more  than  twenty  minutes  on  any  day, 
except  by  special  permission  of  the  Superintendent,  and  are  not  to  converse 
with  any  patient  who  is  not  a  relative  or  friend. 

Not  more  than  two  persons  will  be  allowed  to  visit  a  patient  at  the  same 
time,  unless  the  patient’s  condition  is  marked  “Dangerous." 

No  visitor  shall  give  tobacco,  drink,  or  food  of  any  kind  to  a  patient. 
All  articles  sent  or  brought  by  visitors  for  patients  must  be  plainly  marked 
and  left  at  the  office,  and  will  be  subject  to  inspection  by  the  hospital 
authorities. 

The  Superintendent  may,  at  his  discretion,  exclude  visitors  from  any 
ward  or  patient. 

Superintendent. — The  Superintendent  of  the  Cincinnati  General 
Hospital  and  of  the  Cincinnati  Tuberculosis  Sanatorium  shall  have  charge 
of  the  general  administration  of  the  Cincinnati  General  Hospital  and  of  the 
Cincinnati  Tuberculosis  Sanatorium,  and  shall  be  a  voting  member  of  the 
Directing  Medical  Staff  and  Secretary  of  same. 

He  shall  have  control  of  all  admissions  to  the  hospital,  and  of  the  final 
discharges. 

As  the  resident  medical  representative  of  the  Board  of  Directors  of 
the  University  of  Cincinnati,  it  shall  be  his  duty  to  see  that  each  patient 
receives  prompt  medical  and  surgical  service  from  the  men  assigned  to 
such  duties.  If  any  member  of  the  staff  fails  to  render  such  service,  he 
shall  call  the  physician’s  attention  to  such  neglect,  and  if  repeated,  then  the 
Superintendent  shall  report  the  facts  to  the  Directing  Medical  Staff  for 
action. 

The  director  of  each  of  the  medical  and  surgical  services  in  the  hos¬ 
pitals  shall  be  responsible  to  the  Superintendent  for  the  keeping  of  complete 
and  accurate  histories  of  all  patients. 


10 


RULES  AND  REGULATIONS 


The  Superintendent  shall  cause  to  be  kept  proper  and  complete  records 
of  all  patients,  showing  name,  address,  age,  residence,  employment,  nativity, 
date  and  terms  of  admission,  date  of  discharge  or  death,  result  of  treatment, 
etc. 

He  shall  cause  to  be  tabulated  at  the  end  of  each  week  a  report  showing 
the  daily  visits  of  each  member  of  the  Attending  Staff,  giving  the  time  of 
arrival  and  departure.  If  anjr  physician  is  irregular  in  his  attendance, 
the  Superintendent  shall  call  his  attention  to  his  dereliction,  and  if  persisted 
in,  then  the  Superintendent  shall  notify  the  Directing  Medical  Staff. 

To  facilitate  the  working  efficiency  of  his  office,  as  his  duties  are 
numerous  and  scattered,  he  shall  be  in  his  office  daily,  with  the  exception  of 
Sundays  and  holidays,  from  8:30  a.m.  to  9:30  a.m.,  which  shall  be  known  as 
his  "official  office  hour.” 

He  shall  keep  accurate  records  of  the  proceedings  of  the  Directing 
Medical  Staff. 

He  shall  cause  relatives  or  nearest  friend  of  any  patient  reported  to  the 
Attending  Physician  as  dangerously  ill  to  be  notified  at  once. 

He  shall  endeavor  in  every  way  possible  to  establish  the  identity  of  all 
unknown  persons  brought  to  the  hospital. 

On  the  decease  of  a  patient,  he  shall  cause  immediate  notice  to  be  sent 
to  the  nearest  relative  or  friend,  and  shall  cause  the  body  to  be  kept  safely 
until  the  expiration  of  the  legal  time  limit.  Every  endeavor  shall  be  made 
to  locate  relatives  or  friends  before  the  body  of  any  deceased  patient  shall 
be  pronounced  unclaimed. 

In  disposing  of  unclaimed  bodies  he  shall  be  governed  by  the  laws  as 
set  forth  in  the  General  Code  of  Ohio. 

Section  9984.  Superintendent  of  City  Hospitals,  directors 
or  superintendents  of  city  or  county  infirmaries,  directors 
or  superintendents  of  workhouses,  directors  or  superintendents 
of  asylums  for  the  insane,  or  charitable  institutions  founded 
and  supported  in  whole  or  in  part  at  public  expense,  the 
directors  or  warden  of  the  penitentiary,  township  trustees, 
sheriffs,  or  coroners,  in  possession  of  bodies  not  claimed  or 
identified,  or  which  must  be  buried  at  the  expense  of  the 
county  or  township,  before  burial  shall  hold  such  bodies  not 
less  than  thirty-six  hours  and  notify  the  professor  of  anatomy 
in  a  college  which  by  its  charter  is  empowered  to  teach  ana¬ 
tomy,  or  the  president  of  a  county  medical  society,  of  the 
fact  that  such  bodies  are  being  so  held.  Before  or  after  burial 
such  superintendent,  director,  or  other  officer,  on  the  written 
application  of  the  professor  of  anatomy,  or  the  president  of  a 
county  medical  society,  shall  deliver  to  such  professor  or 
president,  for  the  purpose  of  medical  or  surgical  study  or 
dissection,  the  body  of  a  person  who  died  in  either  of  such 
institution,  from  any  disease  not  infectious,  if  it  has  not  been 
requested  for  interment  by  any  person  at  his  own  expense. 


CINCINNATI  MUNICIPAL  HOSPITALS 


1 1 


History.  R.  S.  No.  3763;  93  v.  84;  78  v.  25,  No.  1, 

Sec.  G.  C.  No.  9985. 

Section  9985.  If  the  body  of  a  deceased  person  so 
delivered  be  subsequently  claimed,  in  writing,  by  a  relative 
or  other  person  for  private  interment,  at  his  own  expense, 
it  shall  be  given  up  to  such  claimant.  (R.  S.  Sec.  3763.) 

History.  R.  S.  No.  3763;  93  v.  84;  78  v.  33;  67  v.  25, 

No.  1. 

The  next  of  kin  of  a  decedent  have  the  right  to  determine 
the  place  and  manner  of  burial. 

Smiley  v.  Bartlett,  6  O.  C.  C.,  234;  3  O.  C.  D.,  432. 

He  shall  send  to  every  member  of  the  Attending  and  Resident  Staffs 
and  Internes  a  copy  of  the  printed  Hospital  Rules  and  Regulations.  It  is 
important  that  every  member  of  the  Attending  and  Resident  Staff  and  every 
Interne  shall  thoroughly  familiarize  himself  with  said  Rules  and  Regulations. 

Nursing  Department. — The  Director  and  Faculty  of  the  School  of 
Nursing  and  Health  shall  be  nominated  to  the  Board  of  Directors  of  the 
University  of  Cincinnati  by  the  Directing  Medical  Staff  of  the  Cincinnati 
General  Hospital. 

The  Director  of  the  School  of  Nursing  and  Health. — The 
nursing  of  all  patients  in  the  Cincinnati  General  Hospital  and  the  Tuber¬ 
culosis  Sanatorium  shall  be  under  the  charge  of  the  Director  of  the  School 
of  Nursing  and  Health,  subject  to  the  approval  of  the  Superintendent  and 
Medical  Director,  and  of  the  Directing  Medical  Staff. 

She  shall  have  supervision  of  the  teaching  in  the  School  of  Nursing  and 
Health,  subject  to  the  approval  of  the  Dean  of  the  College  of  Medicine. 

She  shall  have  supervision  of  all  other  employes  in  the  Nursing  Depart¬ 
ment. 

She  shall  recommend  to  the  Superintendent  all  appointments  affecting 
the  Nursing  Department. 

On  the  request  of  the  Superintendent  she  shall  suspend  or  dismiss  any 
graduate  or  pupil  nurse  who  has  committed  an  act  detrimental  to  the 
welfare  of  a  patient  or  the  discipline  of  the  hospital. 

She  shall  send  to  the  Dean  of  the  College  of  Medicine  for  his  approval 
a  detailed  report  in  all  cases  of  dismissal  of  pupil  nurses  from  the  School  of 
Nursing  and  Health,  stating  fully  the  reasons  for  such  action. 

It  shall  be  her  duty  to  direct  her  assistants,  supervisors,  and  head 
nurses  in  the  principles  and  practices  of  nursing  and  ward  management, 
and  to  see  that  the  wrork  of  all  nurses  and  employes  in  her  department 
is  properly  performed. 

In  order  that  members  of  the  Medical  Staff  and  others  may  know 
when  they  can  interview  her,  she  shall  be  in  her  office  daily  from  9:00  a.m. 
to  10:00  a.m.,  Sundays  and  holidays  excepted. 

Authority  of  Faculty  of  School  of  Nursing  and  Health. — Senior 
and  Junior  student  nurses,  not  in  charge,  shall  receive  directions  for  medical 


12 


RULES  AND  REGULATIONS 


care  and  treatment  of  patients  from  the  head  nurse  or  Senior  in  charge  of 
the  ward,  who  shall  be  responsible  for  the  execution  of  all  orders  given  by 
the  physicians.  All  nurses,  whether  head  nurses,  graduates,  or  undergradu¬ 
ates,  shall,  in  all  procedures,  be  under  the  direction  and  supervision  of 
the  Faculty  of  the  School  of  Nursing  and  Health,  whose  duty  it  shall  be  to 
maintain  the  highest  possible  nursing  standards. 

Authority  of  Attending  and  House  Staffs. — The  nurse  in  charge 
of  each  ward  shall  receive  and  attend  to  the  execution  of  all  orders  con¬ 
cerning  the  medical  care  of  patients  from  the  Attending  or  Resident  Staff, 
or  from  Internes,  who  are  assigned  by  either  of  the  former  to  the  care  of  any 
patient.  Orders  given  directly  by  the  Attending  Staff  to  the  nurse  in 
charge,  when  the  Resident  is  not  present,  shall  be  carried  out,  and  shall  be 
communicated  to  the  Resident  on  his  next  visit  to  the  ward.  Nurses  shall 
accompany  the  Attending  Staff  and  Resident  Staff  on  rounds,  and  shall 
render  such  assistance  and  give  such  information  as  may  be  required. 
Nurses  shall  carry  out  only  such  medical  orders  as  are  signed. 

Division  of  Authority. — The  head  nurse  or  nurses  in  charge  of  wards, 
whether  graduate  or  undergraduate,  shall  be  under  the  direction  of  the 
Attending  and  Resident  Staff  in  matters  relating  to  the  medical  care  of 
patients,  and  under  the  supervision  of  the  Faculty  of  the  School  of  Nursing 
and  Health  in  matters  relating  to  government  and  discipline. 

Assistant  Director  of  Nurses. — The  Assistant  Director  of  Nurses 
shall  assist  the  Director  of  Nurses  in  the  performance  of  her  duties,  and 
during  her  absence  shall  discharge  the  duties  of  the  Director. 

Night  Supervisor. — The  Night  Supervisor  shall  have  direction  of  the 
nursing  at  night,  and  shall  act  for  the  Director  of  Nurses,  and  for  the 
Superintendent  of  the  Hospital.  She  shall  perform  such  other  duties  as 
the  Superintendent  of  the  Hospital  and  the  Director  of  Nurses  may  desig¬ 
nate. 

Assistant  Night  Supervisor. — The  Assistant  Night  Supervisor  shall 
perform  such  duties  as  the  Director  of  Nurses  or  the  Night  Supervisor  may 
require,  and  shall  act  as  Night  Supervisor  in  her  absence. 

Supervisor  of  Nurses  at  Contagious  Group  of  the  Cincinnati 
General  Hospital. — The  Supervisor  of  Nurses  at  the  Contagious  Group 
shall,  under  the  direction  of  the  Superintendent  of  the  Hospital  and  the 
Director  of  Nurses,  have  immediate  supervision  of  the  administration  of 
the  Contagious  Department.  In  all  matters  pertaining  to  the  medical 
care  of  the  patients  she  shall  be  under  the  Director  of  the  Contagious 
Department,  and  the  Director  of  the  School  of  Nursing  and  Health. 

Supervisor  of  Nurses  at  the  Tuberculosis  Sanatorium. — The 
Supervisor  of  Nurses  at  the  Tuberculosis  Sanatorium  shall,  under  the 
direction  of  the  Director  of  the  School  of  Nursing  and  Health,  and  the 
Resident  Medical  Director,  have  immediate  supervision  of  all  nursing  in 
the  Tuberculosis  Sanatorium. 


CINCINNATI  MUNICIPAL  HOSPITALS 


13 


Dietitians. — The  Dietitians  shall,  under  the  direction  of  the  Super¬ 
intendent  of  the  Hospital,  and  of  the  Director  of  Nurses,  have  charge  of 
the  ordering,  preparing,  and  serving  of  all  diets  for  patients,  subject  to 
the  order  of  the  Medical  Staff.  The}’  shall  perform  such  other  teaching 
and  supervising  duties  as  the  Director  of  Nurses  or  her  assistants  may 
designate. 

Supervisors  and  Assistant  Supervisors. — The  Supervisors  shall, 
under  the  direction  of  the  Director  of  Nurses  and  her  assistants,  have 
supervision  of  the  buildings  of  their  respective  departments.  They  shall 
see  that  all  orders  and  instructions  regarding  the  care  of  wards  and  rooms 
are  carried  out,  and  shall  see  that  there  is  no  waste  or  improper  use  of  any 
article  of  hospital  property.  They  shall  attend,  under  the  direction  of  the 
Director  of  Nurses  and  her  assistants,  to  all  business  transacted  between 
the  executive  officers  of  the  hospital  and  the  pavilions  under  their  charge, 
and  shall  see  that  directions  given  for  nursing  care  of  patients  are  carefully 
executed.  They  shall  perform  such  other  duties  as  the  Director  of  Nurses 
and  her  assistants  may  designate. 

Head  Nurses. — Head  nurses,  whether  graduate  or  undergraduate, 
shall,  under  the  supervision  of  the  Director  of  Nurses  and  her  assistants, 
have  charge  and  care  of  wards  assigned  them,  and  of  the  nursing  of  patients 
therein.  They  shall  be  responsible  for  the  obedience  and  deportment  of 
the  nurses  under  them,  and  also  for  that  of  the  attendants,  orderlies,  and 
w’ard  maids.  They  shall  attend  to  the  carrying  out  of  all  special  rules 
made  for  the  government  of  patients.  They  shall  see  that  the  wards  are 
kept  clean  and  in  good  order.  They  shall  perform  such  other  duties  as 
the  Director  of  Nurses  and  her  assistants  may  designate. 

Nurses  on  General  Duty. — Graduate  or  student  nurses  on  general 
duty  shall  be  assigned  to  wards  for  either  day  or  night  duty,  and  shall 
carefully  carry  out  the  instructions  of  the  head  nurse  for  the  nursing  of 
patients,  and  for  the  care  of  the  ward  and  all  utensils  therein.  They  shall 
perform  all  nursing  procedures  according  to  the  standards  set  by  the  Director 
and  Faculty  of  the  School  of  Nursing  and  Health.  They  shall  be  subject 
to  all  special  rules  w’hich  may  be  made  for  the  government  of  the  wards. 

Male  Attendants  and  Orderlies. — Male  attendants  and  orderlies 
shall  perform  such  duties  in  the  wards  as  may  be  assigned  to  them  by  the 
Director  of  Nurses,  under  the  supervision  of  the  head  nurse. 

Ward  Maids. — Ward  maids  in  all  wards  shall  perform  such  duties 
as  may  be  assigned  to  them  by  the  Director  of  Nurses  and  her  assistants, 
under  the  supervision  of  the  head  nurse. 

Porters. — Porters  shall  perform  such  work  as  the  supervisors  or 
head  nurses  of  their  respective  buildings  may  assign  to  them. 

Other  Workers. — Cooks,  chambermaids,  waitresses,  housemen,  and 
all  other  workers  assigned  to  the  nurses’  residences  of  the  hospitals  shall 
perform  such  work  as  the  supervisors  of  their  respective  buildings  may 
assign  to  them  in  the  various  positions  which  they  have  been  selected  to  fill. 


14 


RULES  AND  REGULATIONS 


Pharmacist. — The  Pharmacist  shall  have  a  registered  pharmacist’s 
certificate  from  the  Ohio  State  Board  of  Pharmacy.  He  shall  consult 
with  the  Superintendent  concerning  his  time  off  duty. 

He  shall  be  an  Instructor  in  the  School  of  Nursing  and  Health  of  the 
College  of  Medicine. 

He  shall  have  one  or  more  assistants  competent  to  put  up  prescrip¬ 
tions,  and  perform  all  duties  devolving  upon  the  Pharmacist.  They  shall 
have  charge  of  the  drug  department  in  the  absence  of  the  Pharmacist, 
and  shall  reside  in  the  hospital. 

The  Pharmacist  shall  have  charge  of  all  the  medicines,  wines,  liquors, 
and  miscellaneous  supplies.  He  shall  inspect  all  of  these,  when  received, 
and  shall  verify  quantity  and  quality  purchased.  He  shall  then  dispense 
them  only  on  orders  properly  signed  by  the  Attending  or  Resident  Staff, 
Internes,  or  Superintendent. 

He  shall  report  without  delay  to  the  Superintendent  the  unauthorized 
use  of  any  wines,  liquors,  or  medicine. 

He  shall  compound  promptly  all  prescriptions  required  for  use  of  the 
patients. 

He  shall  manufacture  all  medicines  that  can  be  conveniently  manu¬ 
factured  in  the  hospital;  keep  an  account  of  all  medical  and  surgical 
supplies;  charge  each  ward  with  the  value  of  each  commodity  sent  to  it; 
and  see  that  all  containers  are  promptly  returned  from  the  wards,  reporting 
to  the  Superintendent  any  neglect. 

At  the  end  of  each  month  he  shall  make  out  a  report  of  the  quantity 
of  each  article  used;  the  value  of  the  medicine  and  supplies  used  in  each 
ward;  and  annually  or  oftener  he  shall  make  a  complete  inventory  of  all 
medicine,  liquors,  supplies,  and  property  belonging  to  his  department, 
together  with  the  value  thereof. 

He  shall  make  requisition  on  the  Superintendent  for  all  drugs  and 
supplies  in  the  operation  of  his  department. 

Rules  for  the  Government  of  the  Hospital  Medical  Library — 
Library  Committee. — The  Cincinnati  General  Hospital  Medical  Library 
shall  be  governed  by  a  Library  Committee  consisting  of  the  Superintendent 
of  Hospitals,  the  Chairman  and  the  Librarian  of  the  Directing  Medical 
Staff,  and  a  Trustee  of  the  Medical  College  Library. 

This  committee  shall  outline  the  general  policy  of  the  library,  recom¬ 
mend  for  appointment  the  Librarian  and  assistants  to  the  Safety  Director, 
authorize  expenditures,  and  recommend  titles  for  purchase. 

All  orders  for  books  and  periodicals  shall  be  approved  by  the  Librarian 
of  the  Directing  Medical  Staff  before  purchase.  He  shall  also  o.k.  all  bills 
for  the  same. 

All  requisitions  for  books  and  library  supplies  shall  be  approved  and 
signed  by  the  Superintendent  of  Hospitals  before  purchase. 

Librarian. — The  Librarian  shall  have  charge  of  the  library  and 
reading  room,  plan  and  supervise  the  work  of  the  assistants  and  custodians, 
be  responsible  for  the  care  of  books  and  other  library  property,  classify 


CINCINNATI  MUNICIPAL  HOSPITALS 


15 


and  arrange  all  books  and  publications,  and  catalogue  same,  according  to 
such  plans  as  shall  be  approved  by  the  Library  Committee,  keep  an  itemized 
account  of  all  money  received  from  fines  and  other  sources,  and  report  the 
amount  to  the  Library  Committee,  and  shall  perform  such  other  duties  as 
the  Superintendent  may  direct. 

Assistant  Librarians. — The  Assistant  Librarians  shall  perform  such 
duties  as  may  be  assigned  by  the  Librarian  and  be  responsible  to  the  Library 
ian  and  Library  Committee.  Any  dealings  with  the  Library  Committee 
shall  be  carried  on  through  the  Librarian. 

Library  Custodian. — The  Library  Custodian  shall  perform  such 
duties  as  may  be  assigned  him  by  the  Librarian.  He  shall  take  books  and 
other  library  material  to  and  from  other  buildings  as  needed,  carry  books 
and  periodicals  to  the  reading  room  and  return  the  same  to  the  shelves  at 
the  request  of  the  Librarian,  and  assist  in  the  reference  work  as  needed. 
Any  spare  time  which  he  may  have  outside  his  duties  as  custodian  may  be 
spent  in  tabulating,  abstracting,  etc.,  for  physicians. 

Suggestions  and  Rules  for  Patrons — Days  and  Hours  for 
Opening. — From  the  first  of  October  to  the  first  of  June  the  library  is 
open  on  all  week  days,  legal  holidays  excepted,  from  8:00  a.m.  to  9:00  p.m. 
During  the  months  of  June,  July,  August,  and  September,  it  is  open  from 
8:00  a.m.  to  5:30  p.m.,  Sundays  and  legal  holidays  excepted. 

Privileges. — 

1.  The  Cincinnati  General  Hospital  Medical  Library  is  open  to  the 
entire  medical  profession  of  Cincinnati  and  vicinity;  also  to  those  interested 
in  the  allied  sciences. 

2.  The  library  is  for  reference  and  not  for  circulation,  except  that 
members  of  the  Attending  and  Resident  Staffs  may,  by  special  permission 
of  the  Librarian,  take  out  such  material  as  may  be  needed  for  a  limited 
time.  This  privilege  does  not  include  current  numbers  of  periodicals. 
Applications  for  special  permission  must  be  signed  on  blanks  for  this  pur¬ 
pose,  which  are  in  the  possession  of  the  Librarian. 

3.  Renewals  may  be  made  by  telephone,  but  no  material  may  be 
renewed  if  any  other  member  of  the  staff  desires  the  same. 

4.  If  a  book,  pamphlet,  or  periodical  be  lost  by  a  patron,  he  shall 
either  replace  it  or  pay  the  value  thereof. 

5.  Any  physician  may,  through  the  library,  borrow  from  the  Surgeon 
General’s  Library,  or  from  the  Library  of  Congress,  material  which  is  not 
in  the  hospital  library,  provided  he  pays  the  expressage  to  and  from  the 
libraries  above  named.  He  shall  be  responsible  for  all  such  material  while 
in  his  possession. 

6.  The  shelves  in  the  reading  and  reference  room  are  open  to  all 
readers,  so  that  material  in  this  room  may  be  freely  examined.  Here  are 
kept  all  current  journals,  bound  journals  frequently  consulted,  medical 


16 


RULES  AND  REGULATIONS 


indices,  and  other  works  of  reference.  Readers  are  requested  to  leave 
books  and  periodicals  on  the  tables  instead  of  returning  them  to  the  shelves 
or  magazine  racks  after  consultation.  Permission  to  use  the  lower  stack 
rooms  must  be  obtained  from  the  Librarian  or  assistant  in  charge. 

7.  The  Librarian  will  be  glad  to  receive  suggestions  in  regard  to 
material  which  it  may  be  desirable  to  add  to  the  library.  Request  blanks 
are  furnished  for  this  purpose,  and  all  such  suggestions  are  presented  to  the 
Library  Committee.  It  is  obvious  that  it  will  be  impossible  to  buy  all 
material  asked  for,  but  requests  will  be  met  as  far  as  possible  with  due  regard 
to  the  quality  of  work,  the  needs  of  the  library,  and  the  limits  of  the  book 
fund. 

The  Librarian  and  assistant  are  ready  at  all  times  to  supply  all  available 
aid  and  information  to  those  seeking  material  on  any  subject. 

Medical  Record  Clerk. — The  Medical  Record  Clerk  shall  have 
charge  of  the  filings  of  all  medical  records  pertaining  to  patients  that  have 
been  discharged.  He  shall  see  that  a  record  of  every  patient  treated  in  the 
hospital  is  sent  to  the  Superintendent’s  office  and  properly  classified  and 
filed. 

He  shall  tabulate  such  statistics  from  the  patients’  records  as  the 
directors  of  the  various  services  and  the  Superintendent  shall  direct. 

He  shall  prepare  an  annual  report  of  all  cases  treated  in  the  hospital. 

He  shall  answer  all  subpoenas  to  court  which  call  for  presentation  of 
the  medical  record  of  any  patient.  Patients’  records  must  never  be  re¬ 
moved  from  the  hospital  by  any  person  (staff  officers  not  excepted)  except 
upon  an  order  from  Court.  Only  members  of  the  Medical  Staff  shall  be 
permitted  to  examine  patients’  records,  except  on  a  written  order  from  the 
Superintendent. 

He  shall  perform  such  other  duties  as  the  Superintendent  shall  direct. 

Medical  Department  of  the  Hospitals. — All  the  medical  work  in 
the  hospitals  shall  be  grouped  under  the  following  heads,  and  known  as 
"Departments,”  while  the  out-patient  department  shall  be  known  as  the 
"Dispensary  of  the  College  of  Medicine  of  the  University  of  Cincinnati.” 


1. 

2. 

3. 

4. 

5. 

6. 

7. 

8. 
9. 

10. 

11. 


Medical 

Surgical  (First,  Second) 

Obstetric 

Pediatric 

Neurological 

Orthopedic 

Gynecological  (First,  Second) 

Dermatological 

Genito-Urinary 

Ophthalmological 

Otological 


CINCINNATI  MUNICIPAL  HOSPITALS  17 

12.  Laryngological 

13.  Pathological 

14.  Bacteriological 

15.  X-ray 

16.  Dental  (General  Hospital  and  Tuberculosis  Sanatorium) 

17.  Contagious 

18.  Tuberculosis 

All  the  physicians  and  surgeons  connected  with,  but  not  residing  in, 
the  hospital  shall  be  known  as  the  “Attending  Staff.” 

There  shall  be  one  Director  at  the  head  of  each  service  (except  in 
9urgery  and  gynecology,  where  there  shall  be  two)  until  funds  are  available 
to  pay  full-time  professors;  then  there  shall  be  only  one  at  the  head  of 
each  department. 

The  Director  of  each  service  shall  be  on  duty  the  entire  year.  He  shall 
have  absolute  control  of  the  whole  service,  including  the  distribution  and 
assignment  of  patients  to  his  medical  associates  in  his  service.  He  shall 
at  all  times  be  responsible  for  the  working  efficiency  of  his  service,  and  for 
the  professional  treatment  of  all  patients  assigned  to  his  service. 

The  Directing  Medical  Staff. — The  directors  of  the  departments 
enumerated  above,  the  Superintendent  of  the  hospitals,  and  the  Dean  of  the 
Faculty  of  the  College  of  Medicine  of  the  University  of  Cincinnati,  shall 
constitute  the  Directing  Medical  Staff.  Nominations  for  directors  shall 
be  forwarded  by  the  Dean  of  the  College  of  Medicine  to  the  President 
of  the  University  for  transmission  to  the  Board  of  Directors  of  the  Uni¬ 
versity  of  Cincinnati.  Said  directors  shall  each  year  after  their  appoint¬ 
ment  by  the  Board  of  Directors  of  the  University  of  Cincinnati  convene 
and  elect  a  chairman  and  vice-chairman.  The  Superintendent  of  the 
General  Hospital  and  Tuberculosis  Sanatorium  shall  be  the  Secretary  and 
voting  member  of  the  Directing  Medical  Staff. 

In  order  to  facilitate  the  co-relation  of  the  work  between  the  various 
departments  and  Nursing  Department  of  the  hospitals,  the  Director  of  the 
School  of  Nursing  and  Health  shall  meet  with  the  Directing  Medical  Staff 
(except  when  the  Chairman  shall  announce  an  executive  session).  She 
shall  have  the  privilege  to  present  and  discuss  any  question  relating  to  the 
Nursing  Department,  but  shall  not  vote. 

The  Directing  Medical  Staff  shall  meet  the  second  Friday  of  every 
month,  but  for  the  months  of  July,  August,  and  September  the  Chairman  of 
the  Directing  Medical  Staff  may,  at  his  discretion,  appoint  a  committee, 
including  the  Superintendent,  who  shall  supervise  the  routine  medical  work 
during  the  three  summer  months  named. 

Assistant  Director. — There  may  be  an  Assistant  Director  in  each 
service  who  shall  be  on  duty  the  entire  year.  In  the  absence  of  the  Director 
for  a  period  of  more  than  three  days,  the  Assistant  Director  shall  take 
charge  of  the  service  during  his  absence,  during  which  time  he  shall  be 


18 


RULES  AND  REGULATIONS 


clothed  with  the  same  power  as  the  Director.  If  there  be  no  Assistant 
Director,  then  one  of  the  Attending  Physicians  or  Surgeons  shall  be  selected 
to  act  during  the  absence  of  the  Director. 

Salaried  assistants  in  the  College  of  Medicine  of  the  University  may 
be  on  continuous  service  in  the  hospital,  irrespective  of  their  rank  in  the 
hospital. 

Attending  Physicians  and  Surgeons. — The  next  in  rank  below  the 
Assistant  Directors  shall  be  known  as  Attending  Physician  and  Surgeon, 
who  may  have  a  rotating  service  of  four  (4)  months  each. 

Any  member  of  the  Attending  or  Resident  Staff  who  receives  a  salary, 
whether  from  the  hospital  or  University,  shall  not  be  connected  with  any  other 
hospital.  Exception  to  this  shall  be  the  X-ray  Department  until  such 
time  as  a  full-time  paid  Director  can  be  secured. 

Members  of  the  Attending  Staff  who  serve  without  compensation  shall  not 
be  affiliated  with  more  than  one  other  hospital. 

Assistant  Attending  Physicians  and  Surgeons. — Next  in  rank 
to  the  Attending  Physicians  and  Surgeons,  the  appointees  shall  be  known 
as  Assistant  Attending  Physicians  and  Surgeons,  and  in  each  service  they 
shall  be  graded  as  first,  second,  third,  etc.,  assistants. 

Appointments  and  Promotions. — In  filling  positions  on  the  staff 
made  vacant  by  death,  resignation,  or  other  causes,  or  to  fill  new  positions, 
time  of  service  shall  be  considered,  but  shall  give  no  one  a  claim  to  advance¬ 
ment.  Ability  and  efficiency  shall  be  given  chief  consideration. 

Volunteer  Physicians  and  Surgeons. — At  the  discretion  of  the 
Director  of  any  one  of  the  medical  or  surgical  services,  and  subject  to  the 
approval  of  the  Directing  Medical  Staff,  there  may  be  appointed  by  the 
Board  of  Directors  of  the  University  of  Cincinnati  Volunteer  Physicians 
and  Surgeons  on  any  service;  but  they  shall  agree  to  serve  not  less  than 
four  (4)  months;  they  shall  serve  without  compensation,  and  shall  not 
reside  in  the  hospital. 

General  Rules. — The  number  of  Attending  Physicians  and  Sur¬ 
geons,  and  Assistant  Attending  Physicians  and  Surgeons,  shall  be  deter¬ 
mined  for  each  service  by  the  Director  of  the  Service,  the  Chairman  of  the 
Directing  Medical  Staff,  and  the  Dean  of  the  College  of  Medicine  of  the 
University  of  Cincinnati. 

When  a  position  below  Director  is  to  be  filled  on  the  Attending  Staff 
of  the  Cincinnati  General  Hospital  or  of  the  Tuberculosis  Sanatorium, 
then  the  Director  on  whose  service  the  appointment  is  to  be  made  shall, 
at  the  next  regular  meeting  of  the  Directing  Medical  Staff,  nominate  one 
or  more  candidates  for  such  position,  indicating  his  preference  by  placing 
the  preferential  candidate  first  on  the  list,  and  so  on.  The  Chairman 
of  the  Directing  Medical  Staff  shall  refer  the  name  or  names  to  a  committee 
of  three,  one  of  whom  shall  be  the  Dean  of  the  College  of  Medicine.  Said 
committee  shall  report  its  findings  at  the  next  meeting  of  the  Directing 


CINCINNATI  MUNICIPAL  HOSPITALS 


19 


Medical  Staff,  and  the  Directing  Medical  Staff  shall  select  by  majority 
ballot  a  candidate  or  candidates  from  such  list  and  present  said  name  or 
names  in  writing  to  the  Board  of  Directors  of  the  University  of  Cincinnati 
for  its  approval. 

All  appointments  to  the  Medical  Staff  of  the  Cincinnati  General 
Hospital  and  the  Tuberculosis  Sanatorium  shall  be  for  one  year. 

The  Board  of  Directors  of  the  University  of  Cincinnati  shall  at  their 
regular  monthly  meeting  in  December  of  each  year  appoint  a  Director 
for  each  department.  The  only  exception  to  this  rule  shall  be  where  for 
special  reasons  a  suitable  man  cannot  be  found  at  that  date.  If  such  a 
condition  arises,  then  they  may  upon  the  recommendation  of  the  Dean  of 
the  Medical  College  make  a  temporary  appointment  with  the  title,  “Director 
pro  tem.”  The  President  of  the  University  shall  within  one  week  notify 
in  writing  each  Director  of  his  appointment. 

The  Directing  Medical  Staff  shall,  through  the  Dean  of  the  College 
of  Medicine,  within  fifteen  days  from  the  date  of  their  appointment  in 
December,  present  to  the  Directors  of  the  University  of  Cincinnati  for 
their  approval,  the  names  of  candidates  for  all  positions  to  be  filled  below 
that  of  Director. 

The  Director  of  a  service  in  the  hospital  shall  be  a  Professor  of  the 
corresponding  department  in  the  College  of  Medicine  of  the  University 
of  Cincinnati. 

Attending  Staff. — 

1.  The  Attending  Staff  when  on  duty  shall  pay  daily  visits  to  their 
services,  and  such  additional  visits  as  perfect  attention  to  their  patients 
may  demand. 

2.  They  shall  respond  to  all  emergency  calls  sent  them  as  promptly 
as  possible.  The  hospital  will  pay,  where  necessary,  for  their  transporta¬ 
tion  to  and  from  the  hospital  between  the  hours  of  12:00  midnight  and 
6:00  a.m. 

3.  Members  of  the  Attending  Staff  shall  sign  all  orders  for  ward 
medical  and  surgical  supplies.  All  requisitions  for  new  therapeutic  agents, 
diagnostic  and  other  instruments  shall  be  signed  by  the  Director  of  the 
service. 

4.  Within  forty-eight  hours  after  the  admission  of  a  patient  the  Attending 
Physician  or  Surgeon  in  charge  of  the  case  shall  write  or  dictate  the  results 
of  his  personal  examination  of  the  patient,  also  his  tentative  diagnosis,  and 
the  Attending  Physician' s  name,  with  date  of  examination,  shall  he  appended 
to  this  report. 

5.  Every  member  of  the  Attending  Staff,  including  the  Contagious 
Department  and  Out-patient  Dispensary,  shall  announce  to  the  telephone 
operators  when  he  enters  and  leaves  the  hospital. 

Consulting  Physicians  and  Surgeons. — Nominations  for  the  posi¬ 
tions  of  Consulting  Physicians  and  Surgeons  shall  be  made  in  writing  by 


20 


RULES  AND  REGULATIONS 


the  Dean  of  the  Medical  College  to  the  President  of  the  University  of 
Cincinnati,  who  shall  transmit  same  to  the  Board  of  Directors  of  the  Uni¬ 
versity  of  Cincinnati  for  approval. 

Consulting  Physicians  and  Surgeons  shall  respond  to  calls  for  con¬ 
sultation  from  the  Attending  Staff.  They  shall  have  the  privilege  of 
visiting  at  any  time  the  services  they  represent. 

Emeritus  Members  of  the  Staff. — A  member  of  the  staff  may, 
upon  retiring  at  the  age  limit  or  before,  (provided  he  has  served  at  least 
ten  [10]  years)  be  given  the  title  of  Emeritus.  This  title  shall  only  be 
conferred  when  the  candidate  has  rendered  special  and  distinguished 
service  to  the  hospital  and  Medical  College,  and  then  only  upon  the  joint 
recommendation  of  the  Faculty  of  the  Medical  Department,  and  the  Direct¬ 
ing  Medical  Staff  of  the  hospital,  to  the  Board  of  Directors  of  the  Uni¬ 
versity  of  Cincinnati. 

Receiving  Physicians. — 

1.  The  Receiving  Physicians  shall  reside  in  the  institution,  and  shall 
devote  their  entire  time  to  their  duties  at  the  hospital. 

2.  The  Chief  Receiving  Physician  shall  have  charge  of  the  Admitting 
Department,  and  shall  direct  the  work  of  his  assistants. 

3.  In  his  absence  one  of  his  assistants  shall  assume  charge  of  the 
department. 

4.  The  Receiving  Physician,  or  his  assistants,  shall  examine  all 
applicants  for  admission  to  the  hospital,  and  if  hospital  treatment  is  required, 
he  shall  designate  the  ward  and  service  to  which  they  are  to  be  sent,  accord¬ 
ing  to  the  schedule  of  distribution  of  cases  as  prepared  bj-  the  Directing 
Medical  Staff. 

5.  If,  after  examination,  he  finds  that  an  applicant  is  not  in  need  of 
hospital  attention  he  shall: 

(a)  Attend  to  his  immediate  needs,  if  surgical  dressing 
or  medical  attention  be  required;  make  note  of  same  with 
diagnosis;  and  file  same. 

( b )  Refer  him  to  the  proper  agency,  clinic,  or  District 
Health  Officer,  etc.,  for  further  treatment. 

6.  He  shall  see  that  the  clerks  make  complete  record  of  the  informa¬ 
tion  required,  on  stationary  supplied,  for  the  purpose  of  identification  of 
applicants  or  their  property. 

7.  When  valuables  are  taken  from  the  person  of  any  applicant  for 
admission,  he  shall  see  that  a  correct  entry  of  their  description  is  made  and 
attested  by  one  or  more  witnesses  before  it  is  placed  in  the  deposit  vault. 

Resident  Staff. — The  Resident  Staff  shall  consist  of  those  physicians 
resident  in  the  hospital,  assigned  to  the  various  services,  who  shall  have 
completed  at  least  one  year  as  internes  in  this  or  any  other  first-class  hos¬ 
pital. 


CINCINNATI  MUNICIPAL  HOSPITALS 


21 


The  senior  resident  on  a  service  shall  be  designated  Resident  Phy¬ 
sician,  Resident  Surgeon,  etc.  Those  next  in  line  shall  be  designated 
First,  Second,  Third,  etc..  Assistant  Resident  Physician  or  Surgeon. 

The  duties  of  the  Resident  Staff  shall  be  as  follows: 

The  Resident  Physician  (Surgeon,  etc.),  under  the  direction  of  the 
Director,  shall  supervise  the  professional  work  of  the  Assistant  Residents 
and  Internes  assigned  to  duty  in  his  department.  He  shall  be  responsible, 
under  the  direction  of  the  Director,  for  the  professional  care  and  treatment 
of  all  patients  in  his  department. 

Upon  the  signed  order  of  the  Director  he,  or,  in  his  absence,  an  Assist¬ 
ant  Resident,  shall  prepare  the  formal  written  recommendations  to  the 
Superintendent  for  the  discharge  of  patients  in  his  department. 

Nominations  for  all  positions  on  the  Resident  Staff  shall  be  made 
similarly  to  those  for  the  Attending  Staff. 

There  shall  be  a  paid  Resident  Physician  in  the  Contagious  Depart¬ 
ment  who  shall  devote  all  his  time  to  said  department.  His  duties  shall 
be  the  same  as  those  defined  for  the  Resident  Physicians  in  other  services. 

A  complete  physical  examination  must  be  made  and  recorded  by  a  member 
of  the  Resident  Staff  or  by  an  Interne  within  two  hours  after  admission  of  a 
patient  to  the  wards. 

A  complete  history  must  be  recorded  in  writing  within  twenty-four  hours 
from  the  time  of  admission  of  a  patient  to  the  wards:  frequent  notes  upon  the 
progress  of  the  case  are  likewise  to  be  recorded. 

Immediately  after  each  operation  there  shall  be  entered  a  description 
of  the  operation,  giving  the  findings  and  diagnosis  as  dictated  by  the  operating 
surgeon. 

Resident  Staff  and  Internes. — The  number  of  Internes  shall  be 
determined  by  the  Directing  Medical  Staff  and  the  Superintendent  of  the 
hospital. 

The  term  of  service  for  Internes  shall  be  fixed  by  the  Directing  Medical 
Staff  and  the  Superintendent  of  the  hospital. 

Internes  shall  be  entitled  to  a  vacation  for  a  period  not  to  exceed  two 
weeks  each  year,  subject  to  the  convenience  of  the  hospital,  and  by  written 
permission  of  the  Superintendent.  They  shall  not  take  vacations  either 
in  the  first  or  the  last  months  of  their  service  in  the  hospital. 

Examination  of  Internes. — The  Directing  Medical  Staff  shall  from 
time  to  time  conduct  competitive  examinations  for  the  positions  of  Internes 
in  the  city  hospitals. 

The  examination  for  Internes  shall  be  open  to  graduates  from  the  two 
medical  schools  at  present  in  Cincinnati,  and  to  graduates  from  Class  "A” 
schools  located  elsewhere. 

Rules  and  Regulations. — 

1.  Internes  shall  reside  in  the  hospital.  They  shall  not  engage  in 
any  other  business  than  that  of  the  hospital,  nor  receive  any  fee  for  any 


22 


RULES  AND  REGULATIONS 


service  rendered  in  the  hospital,  except  for  signatures  of  legal  papers  and 
court  summons. 

2.  No  diploma  or  certificate  of  time  served  in  the  hospital  shall  be 
granted  to  any  Interne  who  shall  resign  or  be  removed,  and  no  Interne  or 
Resident  Surgeon  or  Resident  Physician  shall  receive  a  diploma  or  certifi¬ 
cate  of  service,  unless  recommended  by  the  Directors  of  the  divisions  on 
which  he  has  served. 

3.  The  Internes  and  Resident  Staff  are  responsible  to  the  Super¬ 
intendent  and  Attending  Staff  for  the  proper  performance  of  their  pro¬ 
fessional  duties,  but  in  all  matters  of  personal  conduct  and  administration 
or  general  duties,  including  the  prompt  and  proper  attention  to  all  of  the 
patients  on  their  respective  services,  and  the  keeping  and  filing  of  complete 
and  accurate  histories  of  their  patients,  they  shall  be  directly  responsible 
to  the  Superintendent. 

4.  They  shall  not  leave  the  hospital  at  any  time  before  1:00  p.m., 
except  by  permission  of  their  Attending  Staff  or  the  Superintendent,  and 
upon  court  summons. 

5.  Not  less  than  ten  of  their  number  shall  remain  at  all  times,  day 
and  night,  in  the  hospital,  in  order  that  all  calls  may  be  promptly  attended 
to. 

6.  On  leaving  the  hospital  each  Interne  must  assign  his  service  to 
some  other  Interne,  who  is  at  that  time  on  a  similar  service  or  has  served 
a  term  on  that  service. 

7.  Internes  shall  register  when  leaving  and  when  returning  to  the 
hospital.  They  shall  visit  the  wards  frequently  but  regularly  before  9:00 
a.m.,  and  between  5:00  p.m.  and  9:00  p.m. 

8.  They  shall  carefully  and  faithfully  attend  to  patients  assigned  to 
them,  and  be  at  all  times  subject  to  the  control  and  direction  of  the  Attend¬ 
ing  Staff,  and  of  the  Superintendent  in  all  matters  pertaining  to  good  order 
and  the  proper  discipline  of  the  house. 

9.  They  shall  be  called  to  the  wards  on  the  admission  of  every  patient 
coming  into  their  service.  Also,  they  may  be  called  to  render  surgical  or 
medical  attention  to  all  patients  admitted  to  the  Receiving  Ward  on  their 
respective  services  during  the  day  or  night,  whose  condition  is  such  as  to 
warrant  temporary  or  permanent  hospital  observation  or  treatment. 
They  shall  be  called  to  the  wards  day  and  night,  whenever  in  the  judgment 
of  the  nurse  in  charge  of  the  ward  the  condition  of  the  patient  warrants. 
Upon  the  death  of  any  patient  the  Interne  shall  be  summoned  by  the  nurse 
in  charge  to  perform  the  death  test. 

10.  All  orders  for  medicines  or  other  treatments  for  patients  shall 
be  made  in  writing  in  the  books  provided  for  that  purpose.  Verbal  orders 
shall  be  ignored. 

11.  In  all  cases  of  emergency  they  shall  at  once  notify  the  Director; 
if  he  cannot  be  reached,  then  the  next  in  charge  of  the  service.  If  neither 
one  can  be  found,  then  they  shall  report  to  the  Superintendent. 


CINCINNATI  MUNICIPAL  HOSPITALS 


23 


12.  Resident  Surgeons  shall  not  operate  upon  any  case  without  the 
sanction  of  the  Attending  Staff  Surgeon,  except  in  cases  of  emergency,  and 
then  only  on  instructions  from  the  Superintendent. 

13.  Internes  shall  not  operate  upon  any  patient  except  under  the  direct 
personal  supervision  of  a  member  of  the  Attending  Staff.  Lumbar  punc¬ 
tures,  aspirations  of  chests  and  abdomens,  venesections  and  similar  pro¬ 
cedures  to  be  determined  by  the  Attending  Staff,  may  be  performed  by  the 
Internes  only  under  the  personal  supervision  of  a  member  of  the  Attending 
or  Resident  Staff. 

14.  They  shall  make  carefully  written  and  complete  histories  of  each 
patient  when  entering,  and  shall  keep  a  daily  record  of  all  cases  where 
indicated,  carefully  noting  the  symptoms,  changes,  and  treatment  of  each. 

15.  They  shall  each  make  a  daily  health  report  of  each  patient  under 
their  charge,  to  the  hospital  office  before  11:00  a.m.,  and  in  the  case  of 
death  of  any  patient  shall  report  immediately  to  the  office  the  name  of  the 
deceased,  with  the  cause  of  death. 

16.  They  shall  report  to  the  office  immediately,  when  any  patient 
is  deemed  dangerously  sick. 

17.  They  shall  report  to  the  office  any  facts  coming  to  their  knowledge 
before  or  after  the  death  of  any  patient,  -which  might  indicate  the  necessity 
for  a  coroner’s  inquest  or  other  action  by  the  police. 

1 8.  The}7  shall  not  transfer  patients  from  one  ward  to  another  except 
on  the  written  order  of  their  staff,  and  with  the  approval  of  the  Superin¬ 
tendent.  In  all  instances  transfers  must  be  made  through  the  hospital 
office  only,  where  the  order  shall  be  stamped  with  the  "time  stamp”  at  the 
time  received. 

19.  They  shall  not  discharge  any  patient  from  the  house  without  an 
order  of  an  Attending  Staff  officer.  They  shall  not  discharge  patients  for 
disorderly  conduct  or  violation  of  the  rules  of  the  hospital,  but  shall  report 
to  the  Superintendent,  for  his  action,  all  facts  in  reference  to  such  cases. 
They  shall  report  to  the  Superintendent  all  patients  desiring  to  leave  the 
hospital  against  the  advice  of  the  Attending  or  Resident  Staff. 

20.  The  descriptive  cards  and  clinical  histories  of  all  patients  reported 
as  ready  to  be  discharged,  must  be  filed  in  the  Clerk’s  office  previous  to  their 
discharge.  In  the  case  of  deaths  these  cards  and  histories  must  be  sent 
with  the  body  to  the  Pathologic  Institute. 

21.  Applications  for  post-mortems  must  be  made  to  the  Pathologist, 
or  in  his  absence  to  the  Assistant  Pathologist,  or,  in  the  absence  of  both, 
to  the  Superintendent  or  Assistant  Superintendents. 

22.  Internes  shall  be  notified  of  and  attend  the  post-mortem  examina¬ 
tion,  when  such  is  made,  of  any  patient  dying  on  the  service  to  which  they 
are  attached.  This  rule  does  not  apply  to  the  Interne  on  duty  in  the 
Obstetrical  Service. 


24 


RULES  AND  REGULATIONS 


23.  Whenever  a  patient  dies  in  the  hospital,  the  physician  or  surgeon 
in  charge  of  said  patient  shall  certify  to  the  cause  of  death. 

24.  Neither  the  Resident  Staff  nor  Interne  shall  render  medical 
attention  to  any  employe  or  nurse,  unless  instructed  to  do  so  by  the  Super¬ 
intendent.  Examination  of  female  patients  shall  not  be  made  by  any 
member  of  the  Resident  Staff,  or  by  an  Interne,  unless  there  be  at  least  one 
nurse  present  during  the  examination. 

25.  They  shall  not  report  cases  for  medical  or  other  journals  without 
express  permission  of  the  Director  of  their  service,  nor  shall  they  communi¬ 
cate  information  respecting  the  hospital  or  their  patients  to  interviewers 
or  reporters. 

26.  They  shall  not  remove  any  apparatus,  furniture,  or  instrument 
from  any  ward  without  furnishing  the  head  nurse  of  such  ward  with  a 
written  and  signed  slip  stating  clearly  what  is  to  be  taken,  and  where  it  is 
to  be  taken,  and  they  shall  see  that  such  articles  are  piomptly  returned 
at  the  earliest  opportunity. 

27.  When  instruments  are  removed  from  the  operating  pavilion,  a 
full  record  of  such  removal,  with  signature,  shall  be  made  on  the  records 
provided  for  that  purpose. 

28.  In  the  absence  of  the  Receiving  Physician  and  his  assistants, 
one  of  the  Resident  Staff  shall  perform  his  duties  in  the  Receiving  Ward, 
and  during  such  time  shall  be  constantly  present  at  the  Receiving  Office 
ready  to  render  immediate  service.  In  the  meantime  he  shall  turn  over  his 
own  regular  duties  to  one  of  his  associates. 

29.  The  Resident  Staff  and  Internes  shall  cultivate  at  all  times  the 
most  friendly  relations  with  the  Superintendent  of  the  hospital,  and  treat 
him  as  the  manager  and  governor  of  the  house,  with  all  due  respect. 

30.  Good  order  and  decorum  must  be  maintained  at  all  times,  and 
the  House  Staff  is  expected,  as  officers  of  the  house,  to  exhibit  an  example 
which  may  be  profitably  copied  by  all  persons. 

31.  Internes  are  cautioned  after  10:00  p.m.,  when  in  their  rooms, 
and  in  passing  to  and  from  them,  to  refrain  from  loud  talking,  and  to  walk 
as  quietly  as  possible  in  order  that  others  may  not  be  disturbed. 

32.  Smoking  in  the  dining-room  or  in  any  other  part  of  the  hospital, 
except  in  the  sleeping  quarters,  recreation  or  assembly  rooms,  is  positively 
forbidden. 

33.  The  use  of  liquor  by  the  House  Staff  during  their  term  of  service, 
while  on  the  hospital  premises,  is  inconsistent  with  their  duty,  and  is  for¬ 
bidden. 

34.  Internes  desiring  a  leave  of  absence  from  the  hospital  for  longer 
than  twenty-four  hours,  except  in  case  of  illness,  shall  obtain  written  per¬ 
mission  from  the  Attending  Staff  officer  in  charge  of  the  respective  service. 
In  case  of  absence  over  night,  the  Superintendent  or  the  Assistant  Super¬ 
intendent  shall  be  previously  notified. 


CINCINNATI  MUNICIPAL  HOSPITALS 


25 


35.  In  matters  concerning  the  Internes,  collectively  or  individually, 
a  committee  of  three  Internes  shall  represent  the  entire  body.  This  com¬ 
mittee  shall  be  chosen  by  the  Internes,  the  choice  to  be  subject  to  the 
approval  of  the  Superintendent. 

36.  The  Superintendent  and  Assistant  Superintendent  have  entire 
charge  of  the  interne  supervision  day  and  night,  and  in  their  absence  the 
Receiving  Physician  or  his  assistants  shall  assume  this  responsibility. 

Anesthetist  and  the  Administration  of  Anesthetics. — A  full¬ 
time  paid  Anesthetist  shall  reside  in  the  hospital  and  devote  all  of  his 
or  her  time  to  the  duties  incident  to  the  administration  of  anesthetics. 

The  Anesthetist  shall  have  general  control  and  direct  the  giving  of 
anesthetics,  subject  to  the  approval  of  the  Surgical  Staff  and  Superintendent, 
and  shall  have,  in  conjunction  with  the  nurse  in  charge  of  the  Operating 
Pavilion,  supervision  of  the  various  anesthetic  appliances,  and  see  to  it 
that  they  are  kept  in  perfect  working  order. 

The  Anesthetist  shall  instruct  the  Internes  in  the  administration  of 
anesthetics  during  the  time  they  are  assigned  to  the  anesthetic  service. 

The  Anesthetist  shall  deliver  two  lectures,  or  more,  if  desired,  on 
"Anesthetics,  Their  Administration  and  Danger,”  each  3'ear  to  the  Senior 
class  in  the  Medical  Department  of  the  University. 

Anesthetics  shall  not  be  administered  by  an  Interne  who  has  not  had 
at  least  one  month  on  the  anesthetic  service,  except  under  the  direct  super¬ 
vision  of  the  full-time  Anesthetist,  a  qualified  Assistant  Anesthetist,  or  a 
member  of  the  Attending  or  Resident  Staff. 

The  Anesthetist  shall  be  on  duty  from  8:00  a.m.  to  12:00  m.,  and  from 
1 :00  p.m.  to  3:00  p.m.  daily,  except  Sundays  and  holidays,  and  at  such  other 
hours  as  the  Superintendent  may  direct. 

The  Anesthetist  shall  respond  to  emergency  calls  at  any  hour. 

Clinical  Clerks. — Clinical  Clerks  are  fourth-year  medical  students. 
They  shall  file  with  the  Superintendent  a  card  of  assignment  to  the  hospital 
service  from  the  office  of  the  Dean  of  the  Medical  School.  They  shall 
report  for  duty  at  the  hospital  at  8:00  a.m.  during  the  period  of  their  assign¬ 
ment.  They  shall  perform  the  work  assigned  them  under  the  immediate 
supervision  of  the  Attending  Staff,  the  Resident  Staff,  and  the  Internes. 

Clinical  Clerks  shall  have  absolutely  no  authority  regarding  treatment 
of  patients,  nor  shall  they  issue  any  orders  to  nurses  or  others  serving  in 
the  wards.  Male  students  are  forbidden  to  make  physical  examination 
of  female  patients  in  the  absence  of  a  nurse. 

The  Director  of  the  Pathologic  Laboratory. — The  Director 
of  the  Pathologic  Institute,  who  shall  also  be  the  Pathologist  and  a  member 
of  the  Attending  Staff,  shall  have  direction  of  all  examinations  of  pathologic 
specimens  and  of  autopsies.  He  shall  have  direct  control,  subject  to  the 
authority  of  the  Superintendent  and  Dean  of  the  Medical  College,  of  the 
management  of  the  Pathological  Building,  and  either  directly  or  through 
his  assistants  (whose  duties  shall  be  designated)  of  the  ward  laboratories, 
and  the  laboratories  of  the  Receiving  Ward  and  Operating  Pavilion. 


26 


RULES  AND  REGULATIONS 


He  shall  specify  the  duties  of  all  his  assistants;  namely,  Resident 
Pathologist,  Clerk  and  Stenographer,  Technicians,  Morgue  Attendant, 
Housemaids,  and  any  other  special  assistants,  who  from  time  to  time  shall 
be  appointed,  and  such  Internes  as  shall  be  assigned  to  laboratory  duty. 
When  necessary,  he  shall  recommend  to  the  Superintendent  dismissal  of 
any  of  his  assistants  who  are  on  the  hospital  pay  roll;  to  the  Dean  of  the 
College  of  Medicine  those  who  are  on  the  University  pay  roll.  In  cases 
other  than  dismissal,  he  shall  have  full  disciplinary  powers  in  his  depart¬ 
ment.  He  shall  recommend  to  the  Superintendent  or  the  Dean  of  the 
College  of  Medicine  all  appointments  affecting  the  laboratory  service. 

He  shall  be  responsible  for  the  physical  condition  of  the  Pathologic 
Institute,  and  for  the  work  accomplished  in  his  department,  and  it  shall 
be  his  duty  to  assign  work  and  to  make  regulations  governing  the  carrying 
out  and  reporting  of  work. 

He  shall  see  that  indexed  records  of  all  routine  work  are  kept,  and  such 
files  shall  embrace  all  examinations  which  are  made  after  the  receipts  of 
requests  made  upon  "special  request”  blanks. 

He,  or  a  designated  assistant,  shall  perform  all  post-mortems  between 
10:00  a.m.  and  12:00  m.,  and  at  such  other  hours  as  may  be  necessary, 
complete  records  of  which  shall  be  kept  according  to  methods  which  he 
shall  determine. 

He  shall  order,  through  the  Superintendent,  all  articles  or  materials 
for  hospital  work  in  the  laboratory,  and  shall,  upon  written  request  from  the 
head  nurse  of  the  ward,  supply  materials  needed  in  the  ward  laboratories. 

In  the  absence  of  the  Director  of  Pathology  or  of  the  Director  of 
Bacteriology,  or  in  the  absence  of  both,  some  one  of  their  assistants  (whom 
they  shall  designate)  will  become  the  Acting  Director. 

The  Director  of  the  Bacteriologic  Laboratory. — The  Director 
of  the  Bacteriologic  Laboratory,  'who  is  also  a  member  of  the  Attending 
Staff,  shall  have  direction  of  all  bacteriologic,  serologic,  and  parasitologic 
examinations. 

He  shall  specify  the  duties  of  all  his  assistants.  When  necessary,  he 
shall  recommend  to  the  Superintendent  dismissal  of  any  of  his  assistants 
who  are  on  the  hospital  payroll;  to  the  Dean  of  the  College  of  Medicine 
those  who  are  on  the  University  payroll.  In  cases  other  than  dismissal, 
he  shall  have  full  disciplinary  powers  in  his  department.  He  shall  recom¬ 
mend  to  the  Superintendent  or  the  Dean  of  the  College  of  Medicine  all 
appointments  affecting  his  laboratory. 

Rules  Governing  the  Laboratories. — 

1.  Any  qualified  person  who  desires  to  avail  himself  of  the  facilities 
of  the  laboratories  of  the  Cincinnati  General  Hospital  and  the  Tuberculosis 
Sanatorium,  may  be  permitted  to  do  so  with  the  consent  of  the  Directors 
of  the  laboratories,  if  it  will  in  no  way  interfere  with  the  regular  hospital 
and  college  work. 

2.  All  materials,  supplies,  and  apparatus  issued  to  any  worker  in  the 


CINCINNATI.  MUNICIPAL  HOSPITALS 


27 


laboratories  will  be  signed  for  on  a  memorandum  by  the  worker  to  whom 
they  are  issued,  and  he  will  be  held  accountable  for  them,  and,  unless  a 
part  of  the  routine  hospital  work,  material  and  breakage  must  be  paid  for. 

3.  All  experiments  done  upon  animals  must  be  conducted  in  a  manner 
which  will  entail  a  minimum  of  pain  and  suffering.  In  every  experiment 
the  animal  must  be  placed  under  the  influence  of  some  effective  anesthetic 
or  drug,  the  action  of  which  must  continue  during  the  whole  course  of  the 
operative  procedures.  At  the  termination  of  a  completed  experiment  the 
animal  must  be  killed  by  a  painless  method. 

4.  Operative  work  on  animals  will  be  done  only  in  the  operating  rooms 
set  aside  for  that  purpose,  except  with  the  express  consent  of  the  Director. 
There  will  be  two  laboratory  assistants  who  will  be  available  for  such  work. 
Special  assistants  may  not  be  called  upon  for  assistance  except  in  very 
special  instances. 

5.  The  workers  in  the  various  divisions  of  the  laboratory  must  confine 
their  demands  for  assistance  to  the  attaches  of  the  division  in  which  they 
are  working. 

6.  In  all  printed  reports  which  are  based  upon  work  done  in  the 
laboratories,  it  shall  be  indicated  that  such  work  has  emanated  “From  the 
Laboratories  of  the  Cincinnati  General  Hospital,”  or  “From  the  Laboratories 
of  the  Cincinnati  Tuberculosis  Sanatorium.” 

7.  Routine  blood  and  urine  examinations  will  be  done  in  the  ward 
laboratories  by  or  under  the  direction  of  the  house  officers. 

8.  Specimens  sent  to  the  laboratory  for  special  examination  will  be 
delivered,  accompanied  by  the  proper  blanks,  to  room  No.  219,  Pathologic 
Institute,  from  which,  after  receiving  a  serial  number,  they  will  be  delivered 
to  the  proper  workers. 

Tuberculosis  Sanatorium 

The  Cincinnati  Tuberculosis  Sanatorium  is  established: 

1.  For  the  care  and  treatment  of  patients  suffering  with 
tuberculosis,  especially  those  in  the  advanced  stages  of  the 
disease. 

2.  For  instructing  medical  students  in  the  diagnosis 
and  treatment  of  tuberculosis. 

3.  For  investigation  and  research  in  tuberculosis. 

4.  For  the  instruction  of  nurses  and  attendants  in  the 
principles  and  practice  of  the  science  of  nursing,  especially 
with  relation  to  tuberculosis. 

Discharge  of  Patients. — Patients  shall  not  be  discharged  from  the 
institution  unless  the  disease  is  quiescent,  and  they  are  no  longer  a  source 
of  menace  to  the  public  health. 

When  patients  leave  the  hospital  against  the  advice  of  the  physician, 
or  without  his  knowledge,  the  Superintendent  shall  endeavor  writh  the  aid 


28 


RULES  AND  REGULATIONS 


of  the  Health  Department  and  Police  Department  (should  that  patient’s 
disease  still  be  active)  to  secure  his  return  to  the  institution. 

The  Superintendent  may  discipline  any  patient  for  improper  conduct 
or  other  violation  of  the  rules. 

Regulations  Regarding  Visitors. — 

Visitors  to  Patients. — Relatives  or  friends  of  patients  will  be  allowed 
to  visit  patients  daily  between  the  hours  of  1:30  p.m.  and  4:30  p.m.,  and 
between  the  hours  of  6:00  p.m.  and  7:00  p.m. 

No  visitors  shall  be  permitted  to  visit  any  patient  at  other  than  regular 
hours,  except  by  special  permission  of  the  Superintendent. 

Visitors  are  not  allowed  to  remain  more  than  one  hour  on  any  day, 
and  are  not  to  converse  with  any  patient  who  is  not  a  relative  or  friend, 
unless  by  special  permission  of  the  Superintendent. 

Not  more  than  three  persons  will  be  allowed  to  visit  a  patient  at  the 
same  time. 

No  visitor  shall  give  tobacco,  drink,  or  food  of  any  kind  to  any  patient. 

All  articles  sent  to  patients  must  be  plainly  marked  and  left  at  the 
office,  where  they  will  be  subject  to  inspection  by  the  hospital  authorities. 

The  Superintendent  may,  in  his  discretion,  exclude  visitors  from  any 
ward  or  patient. 

Executive  Officers  of  the  Sanatorium. — 

1.  Superintendent 

2.  Assistant  Superintendent  and  Resident  Physician 

3.  Resident  Medical  Director 

4.  Director  of  the  School  of  Nursing  and  Health 

Superintendent  and  Medical  Director. — The  Superintendent 
shall  have  charge  of  the  general  administration  of  the  Cincinnati  Tuber¬ 
culosis  Sanatorium  in  addition  to  his  duties  at  the  Cincinnati  General 
Hospital. 

Rules  governing  his  office  at  the  Cincinnati  General  Hospital  shall 
also  apply  to  his  work  at  the  Sanatorium. 

Resident  Medical  Director. — There  shall  be  one  Medical  Director 
who  shall  be  responsible  for  the  medical  treatment  of  all  the  patients. 
He  shall  supervise  the  work  of  the  other  medical  and  laboratory  attendants. 
He  shall  be  a  member  of  the  Directing  Medical  Staff  of  the  Cincinnati 
General  Hospital  and  Tuberculosis  Sanatorium. 

Director  of  the  School  of  Nursing  and  Health. — The  Director 
of  Nurses  in  the  Cincinnati  General  Hospital  shall  be  the  executive  head 
of  the  Nursing  Department  of  the  Tuberculosis  Sanatorium. 

Assistant  Medical  Director. — There  shall  be  one  Assistant  Medical 
Director,  who  shall  be  on  continuous  service. 


CINCINNATI  MUNICIPAL  HOSPITALS 


29 


Assistant  Resident  Physicians. — 

1.  The  Assistant  Resident  Physicians  shall  be  under  the  direction 
of,  and  responsible  to,  the  Medical  Director. 

2.  -They  shall  not  be  absent  from  duty  without  the  consent  of  the 
Medical  Director  and  Assistant  Superintendent. 

3.  They  shall  visit  all  the  wards  twice  daily  and  oftener,  if  necessary. 
They  shall  be  subject  to  the  orders  of  the  Medical  Director  in  all  matters 
pertaining  to  the  medical  administration  of  the  sanatorium. 

Attending  Physicians,  Surgeons,  and  Assistants  in  the  Labora¬ 
tories. — The  number  of  physicians,  surgeons,  and  assistants  in  the  labora¬ 
tories  shall  be  determined  by  the  Directing  Medical  Staff,  subject  to  the 
approval  of  the  Board  of  Directors  of  the  University  of  Cincinnati. 

Internes. — The  number  of  Internes  assigned  to  the  Tuberculosis 
Sanatorium  shall  be  determined  by  the  Directing  Medical  Staff,  subject 
to  the  approval  of  the  Superintendent. 

Volunteer  Medical  Residents. — There  may  be  one  or  more  Volun¬ 
teer  Medical  Residents  appointed,  who  shall  receive  maintenance,  but  no 
pay.  They  must  be  graduates  of  a  recognized  medical  college,  and  agree 
to  serve  not  less  than  six  months.  At  the  end  of  their  term,  if  their  service 
has  met  with  the  approval  of  the  Medical  Director,  they  shall  receive  a 
certificate  of  service,  signed  by  the  Medical  Director,  the  Superintendent, 
and  the  Dean  of  the  Medical  College. 

Supervisor  of  Nurses. — 

1.  The  Supervisor  of  Nurses  shall  be  under  the  direction  of,  and 
responsible  to,  the  Director  of  the  School  of  Nursing  and  Health  of  the 
Cincinnati  General  Hospital. 

2.  She  shall  frequently  confer  with  and  report  to  the  Assistant  Super¬ 
intendent  and  the  Medical  Director  concerning  the  Nursing  Department 
at  the  institution. 

Pharmacist. — 

1.  The  Pharmacist  shall  be  on  duty  in  the  Drug  Department  from 
7 :30  a.m.  to  12:00  m.,  and  from  1 :00  p.m.  to  4:30  p.m. 

2.  He  shall  compound  and  dispense  such  medicines  as  may  be  re¬ 
quired. 

3.  He  shall  issue  supplies  only  upon  orders  duly  signed,  and  shall 
keep  a  record  of  all  supplies  received  and  issued  each  day. 

4.  He  shall  take  care  of  the  personal  property  of  the  Drug  Depart¬ 
ment  and  render  strict  account  of  the  same  to  the  Superintendent. 


30 


R  ULES  A  ND  REG  ULA  TIONS 


Dietitian. — 

1.  The  Dietitian  shall  be  under  the  direction  of,  and  responsible  to, 
the  Superintendent  or  Assistant  Superintendent,  and  the  Director  of 
Nurses. 

2.  She  shall  supervise  the  work  of  all  her  assistants  in  the  Culinary 
Department. 

3.  She  shall  prepare  menus  for  officers,  employes,  and  patients,  and 
shall  see  that  these  are  properly  cooked  and  served. 

4.  She  shall  prepare  such  special  diets  as  may  be  ordered  by  the 
physicians. 

5.  She  shall  keep  an  accurate  record  of  the  work  done  by  her  depart¬ 
ment. 

6.  She  shall  consult  with  the  Medical  Director  on  the  question  of 
the  selection  and  preparation  of  foods. 


3  0112  1057385 


